Provider Demographics
NPI:1437789419
Name:CARLSON, LINDA ARNETTA (MT-BC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ARNETTA
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E WYOMISSING BLVD APT 26B
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-2116
Mailing Address - Country:US
Mailing Address - Phone:973-903-7792
Mailing Address - Fax:
Practice Address - Street 1:1100 E WYOMISSING BLVD APT 26B
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-2116
Practice Address - Country:US
Practice Address - Phone:973-903-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-18
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist